Fernández-de-Las-Peñas César, Ambite-Quesada Silvia, Palacios-Ceña María, Guillem-Mesado Amparo, Guerrero-Peral Ángel, Pareja Juan A, Arendt-Nielsen Lars
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón.
Department of Health Science and Technology, School of Medicine, Center for Sensory-Motor Interaction (SMI), Aalborg University, Aalborg, Denmark.
Clin J Pain. 2019 Apr;35(4):345-352. doi: 10.1097/AJP.0000000000000684.
The aims of this study were: (1) to investigate the association between the rs4680 Val158Met polymorphism in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH); and (2) to analyze the association between the rs4680 Val158Met polymorphism with clinical, psychological, or psychophysical variables.
In total, 50 women with FETTH, 50 with CTTH, and 50 matched headache-free women participated. After amplifying Val158Met polymorphism by polymerase chain reaction, the genotype frequencies and allele distributions based on restriction fragment length polymorphism were assessed. Participants were classified according to the Val158Met polymorphism rs4680 genotype (Val/Val, Val/Met, or Met/Met). A headache diary collected clinical features. Disability (Headache Disability Inventory), sleep quality (Pittsburgh Sleep Quality Index), and depression/anxiety levels (Hospital Anxiety and Depression Scale) were also assessed. Pressure pain thresholds were assessed bilaterally over the temporalis, upper trapezius, second metacarpal, and tibialis anterior by a blinded assessor.
The distribution of rs4680 Val158Met genotype was not significantly different between women with/without headache (P=0.796). No differences in headache features, disability, anxiety, or sleep quality were observed depending on the rs4680 Val158Met genotype. Women with CTTH, but not FETTH, carrying the Met/Met genotype had lower widespread pressure pain thresholds and higher depressive symptoms than those with Val/Val or Val/Met genotype (P<0.05).
The Val158Met polymorphism (rs4680) does not appear to be involved in predisposition to tension-type headache; however, this genetic factor may be involved in the pathogenesis expression of CTTH, as greater pressure pain sensitivity and higher depressive levels were found in CTTH carrying the Met/Met genotype.
本研究的目的为：（1）调查常见发作性紧张型头痛（FETTH）和慢性紧张型头痛（CTTH）中rs4680 Val158Met多态性之间的关联；以及（2）分析rs4680 Val158Met多态性与临床、心理或心理生理变量之间的关联。
共有50名患有FETTH的女性、50名患有CTTH的女性以及50名匹配的无头痛女性参与。通过聚合酶链反应扩增Val158Met多态性后，基于限制性片段长度多态性评估基因型频率和等位基因分布。参与者根据rs4680基因型（Val/Val、Val/Met或Met/Met）进行分类。头痛日记收集临床特征。还评估了残疾程度（头痛残疾量表）、睡眠质量（匹兹堡睡眠质量指数）以及抑郁/焦虑水平（医院焦虑抑郁量表）。由一名盲法评估者双侧评估颞肌、上斜方肌、第二掌骨和胫骨前肌的压痛阈值。
有/无头痛的女性之间rs4680 Val158Met基因型的分布无显著差异（P = 0.796）。根据rs4680 Val158Met基因型，未观察到头痛特征、残疾程度、焦虑或睡眠质量存在差异。携带Met/Met基因型的CTTH女性，而非FETTH女性，与携带Val/Val或Val/Met基因型的女性相比，具有更低的广泛压痛阈值和更高的抑郁症状（P < 0.05）。
Val158Met多态性（rs4680）似乎不参与紧张型头痛的易感性；然而，这一遗传因素可能参与CTTH的发病机制表达，因为在携带Met/Met基因型的CTTH中发现了更高的压痛敏感性和更高的抑郁水平。
